Medication therapy management (MTM): a tool for optimizing clinical and economic outcomes in the management of chronic diseases

Abstract

Medication Therapy Management (MTM) is an innovative pharmacist-led and delivered pharmacy service that aims to resolve drug therapy problems, improve patient education and increase medication adherence. This dissertation sought to evaluate the impact of receiving MTM services on clinical, economic and behavioral outcomes. The first manuscript showed that diabetes patients exposed to MTM were more likely to meet the glycosylated hemoglobin clinically defined goal compared to a control group of diabetes patients. The second manuscript showed that diabetes patients who took insulin or had diabetes complications were more likely to receive a higher number of MTM visits. The third manuscript showed that patients who took four or more chronic medications had a significant cost reduction seven months after the first MTM encounter compared to a matched cohort of patients who were never exposed to MTM services. Similar results were observed in the fourth manuscript which examined the economic outcomes in diabetes patients who were taking insulin. The last manuscript showed that MTM services resulted in improvement in medication adherence (measured by proportion of days covered (PDC)) across five different classes of chronic disease medications. Taken together, this body of work shows that MTM services is a potential tool that could be used by policy makers and health plan administrators to improve patient outcomes across multiple dimensions of care.